• Karen Donelan, Yuchiao Chang, Holly Matulewicz, Kimberly Warsett, Dennis Heaphy, and Lisa I Iezzoni.
• Health Policy Research Center, The Mongan Institute, Massachusetts General Hospital , Boston, MA, USA. kdonelan@partners.org.
• J Gen Intern Med. 2020 Aug 1; 35 (8): 227422802274-2280.

BackgroundMassachusetts One Care was the first program approved among the Centers for Medicare & Medicaid Financial Alignment Demonstrations for dually eligible beneficiaries. The only program focusing on dually eligible beneficiaries ages 21-64, One Care espouses an independent living philosophy for persons with disabilities. Researchers engaged with enrollees to develop new measures of enrollee quality of life and health to understand changes experienced in this new model of care.ObjectiveTo examine whether enrollee knowledge of care plans and care teams predicts improvements in enrollee reported quality of life outcomes.Design And ParticipantsWe engaged with people with disabilities to develop and implement a longitudinal survey in One Care in Massachusetts. This analysis presents the self-reported outcomes of a panel of 315 enrollees' experiences with key plan features in Massachusetts One Care enrollees.Main MeasuresKnowledge of care plan, care team, and long-term services and supports (predictors); overall health, improved control, improved quality of health care, and improved hope for the future (outcomes).Key ResultsEnrollee-reported knowledge of a care plan and a care team over 2 years of enrollment in Massachusetts One Care was associated with increased odds of reporting more control over health (OR 2.58, CI 1.33, 5.03), improved health care quality (OR 3, CI 1.27, 7.06), and overall health (OR 2.07, CI 1.05, 4.08). Access to new services or equipment to live independently was associated with increased odds of reporting all four positive outcomes, notably for improved perceptions of hope (OR 2.33, CI 1.56, 5.39), overall health (OR 5.03, CI 2.44, 10.39), and improved quality of care (OR 4.22, CI 1.85, 9.62).ConclusionEngagement of persons with disabilities in care teams and care planning, as well as quality measurement, can improve their experiences of quality of life and health care.

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